HVD Exploratory Analysis for County
Disaggregation
Lareina La Flair, Health Policy Institute of Ohio
2022-11-18
1 Background
HPIO has an emerging need to produce choropleth maps for visualizing an aggregate summary of some condition or outcome (e.g., population density, percent Black race, social vulnerability, suicide deaths) across Ohio counties for the Health Value Dashboard.
For the 2023 Health Value Dashboard, we are tasked with identifying metrics for county disaggregation. The metrics below are Ohio-specific and are intended to be presented jointly, pairing one community condition measure with a health outcome at the county level. This analysis is exploratory.
2 Make the maps
Read in the dataset with the health event or condition you’re looking to map.
Here we are using Social Vulnerability Index by county from the Ohio Department of Health Public Health Data Warehouse
(After cleaning) The data have the following columns: *
county as Ohio county of residence * index
expressed as number of deaths per 100K population
2.1 Load the shape files
Here, we read in the shape file for counties, filtered to Ohio counties. Centroids are the mathematical center of a geographic unit (here, counties).
2.2 Spatial joins
Spatially join the outcome (here, deaths) to the geographic unit (here, counties).
2.3 Basic interactive maps
`Set up color palettes, popups, and base layers -- putting it all together using the [leaflet`
package](https://rstudio.github.io/leaflet/).
4 Mental Health Provider Maps
Pairings with Mental Health Providers:
- Mental Health Providers and Suicide Deaths by County
- Mental Health Providers and Overdose Deaths by County
4.1 Pairing 4: Mental Health Providers and Suicide Deaths by County
Data sources:
County Health Rankings:
County Health Ranking Mental Health Providers: Ratio of the population to mental health providers. The ratio represents the number of individuals served by one mental health provider in a county. Ratio of population to mental health providers. The 2022 County Health Rankings used data from 2021 for this measure.
Access to care requires not only financial coverage, but also access to providers. Nearly thirty percent of the population lives in a county designated as a Mental Health Professional Shortage Area. As the mental health parity aspects of the Affordable Care Act create increased coverage for mental health services, many anticipate increased workforce shortages.
Mental Health Providers is the ratio of the population to mental health providers. The ratio represents the number of individuals served by one mental health provider in a county, if the population was equally distributed across providers. For example, if a county has a population of 50,000 and has 20 mental health providers, their ratio would be: 2,500:1.
Ohio Department of Health Public Health Warehouse
Filters applied:
by County for County = (Adams, Allen, Ashland, Ashtabula, Athens, Auglaize, Belmont, Brown, Butler, Carroll, Champaign, Clark, Clermont, Clinton, Columbiana, Coshocton, Crawford, Cuyahoga, Darke, Defiance, Delaware, Erie, Fairfield, Fayette, Franklin, Fulton, Gallia, Geauga, Greene, Guernsey, Hamilton, Hancock, Hardin, Harrison, Henry, Highland, Hocking, Holmes, Huron, Jackson, Jefferson, Knox, Lake, Lawrence, Licking, Logan, Lorain, Lucas, Madison, Mahoning, Marion, Medina, Meigs, Mercer, Miami, Monroe, Montgomery, Morgan, Morrow, Muskingum, Noble, Ottawa, Paulding, Perry, Pickaway, Pike, Portage, Preble, Putnam, Richland, Ross, Sandusky, Scioto, Seneca, Shelby, Stark, Summit, Trumbull, Tuscarawas, Union, Van Wert, Vinton, Warren, Washington, Wayne, Williams, Wood, Wyandot) , External Injury Intent = (Suicide) , Year = (2020, 2021 **) , Res State = (OH)
2021 and 2020 pooled due to low numbers.
4.2 Pairing 5: Mental Health Providers and Overdose Deaths by County
Data Source
County Health Rankings:
County Health Ranking Mental Health Providers: Ratio of the population to mental health providers. The ratio represents the number of individuals served by one mental health provider in a county. Ratio of population to mental health providers. The 2022 County Health Rankings used data from 2021 for this measure.
Access to care requires not only financial coverage, but also access to providers. Nearly thirty percent of the population lives in a county designated as a Mental Health Professional Shortage Area. As the mental health parity aspects of the Affordable Care Act create increased coverage for mental health services, many anticipate increased workforce shortages.
Mental Health Providers is the ratio of the population to mental health providers. The ratio represents the number of individuals served by one mental health provider in a county, if the population was equally distributed across providers. For example, if a county has a population of 50,000 and has 20 mental health providers, their ratio would be: 2,500:1.
Ohio Department of Health Public Health Warehouse
Filters applied:
by County for County = (Adams, Allen, Ashland, Ashtabula, Athens, Auglaize, Belmont, Brown, Butler, Carroll, Champaign, Clark, Clermont, Clinton, Columbiana, Coshocton, Crawford, Cuyahoga, Darke, Defiance, Delaware, Erie, Fairfield, Fayette, Franklin, Fulton, Gallia, Geauga, Greene, Guernsey, Hamilton, Hancock, Hardin, Harrison, Henry, Highland, Hocking, Holmes, Huron, Jackson, Jefferson, Knox, Lake, Lawrence, Licking, Logan, Lorain, Lucas, Madison, Mahoning, Marion, Medina, Meigs, Mercer, Miami, Monroe, Montgomery, Morgan, Morrow, Muskingum, Noble, Ottawa, Paulding, Perry, Pickaway, Pike, Portage, Preble, Putnam, Richland, Ross, Sandusky, Scioto, Seneca, Shelby, Stark, Summit, Trumbull, Tuscarawas, Union, Van Wert, Vinton, Warren, Washington, Wayne, Williams, Wood, Wyandot) , External Injury Intent = (Unintentional) , External Injury Mechanism Group = (Poisoning) , Year = (2020, 2021 **) , Res State = (OH)
2021 and 2020 pooled due to low numbers.
End transmission!
3 Social Vulnerability Index Maps
Pairings with Social Vulnerability Index:
3.1 Pairing 1: SVI and Infant Mortality by County
Data sources:
Social Vulnerability Index
Social Vulnerability Index by county comes from the Ohio Department of Health Public Health Data Warehouse Social Vulnerability Index (SVI) created by the US Centers for Disease Control and Prevention (CDC), using the most current data available from the US Census Bureau American Community Survey 5-year estimates (2014-2018). The SVI is a score ranging from 0 – 1 and is comprised of 15 indicators grouped into 4 themes: Socioeconomic Status (Below Poverty, Unemployed, Income, No High School Diploma), Household Composition & Disability (Aged 65 and Older, Aged 17 and Younger, Civilian with a Disability, Single-Parent Households), Minority Status & Language (Minority, Speak English “Less than Well”), Housing & Transportation (Multi-Unit Structures, Mobile Homes, Crowding, No Vehicle, Group Quarters)
3.2 Pairing 2: SVI and Low Birth Weight by County
Data sources:
County Health Rankings Percentage of live births with low birthweight (< 2,500 grams). The 2022 County Health Rankings used data from 2014-2020 for this measure.
Low birth weight
Social Vulnerability Index
Social Vulnerability Index by county comes from the Ohio Department of Health Public Health Data Warehouse Social Vulnerability Index (SVI) created by the US Centers for Disease Control and Prevention (CDC), using the most current data available from the US Census Bureau American Community Survey 5-year estimates (2014-2018). The SVI is a score ranging from 0 – 1 and is comprised of 15 indicators grouped into 4 themes: Socioeconomic Status (Below Poverty, Unemployed, Income, No High School Diploma), Household Composition & Disability (Aged 65 and Older, Aged 17 and Younger, Civilian with a Disability, Single-Parent Households), Minority Status & Language (Minority, Speak English “Less than Well”), Housing & Transportation (Multi-Unit Structures, Mobile Homes, Crowding, No Vehicle, Group Quarters)
3.3 Pairing 3: SVI and Food Insecurity
Data source:
County Health Rankings
Percentage of population who lack adequate access to food. The 2022 County Health Rankings used data from 2019 for this measure.
Food insecurity
Social Vulnerability Index
Social Vulnerability Index by county comes from the Ohio Department of Health Public Health Data Warehouse Social Vulnerability Index (SVI) created by the US Centers for Disease Control and Prevention (CDC), using the most current data available from the US Census Bureau American Community Survey 5-year estimates (2014-2018). The SVI is a score ranging from 0 – 1 and is comprised of 15 indicators grouped into 4 themes: Socioeconomic Status (Below Poverty, Unemployed, Income, No High School Diploma), Household Composition & Disability (Aged 65 and Older, Aged 17 and Younger, Civilian with a Disability, Single-Parent Households), Minority Status & Language (Minority, Speak English “Less than Well”), Housing & Transportation (Multi-Unit Structures, Mobile Homes, Crowding, No Vehicle, Group Quarters)